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Welcome back to this video

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series on using technology in health care.

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In this particular video, we're going
to be talking about how to assess

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vital signs,
specifically your patient's pulse.

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But pretending and using our mannequin

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before we think about how
we can assess our mannequins pulse,

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we need to actually understand
what a pulse is.

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So when our heart contracts, we know that
it sends blood around the body.

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And you can feel that contraction
within the arteries.

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So as the blood is pumped through
the arteries will also

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have a flow of blood going through them.

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So you can palpate that that's the fancy
word for feel, using your fingers.

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So we usually use our first
and second fingers.

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And the most common place
that you would feel

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for someone's
pulse is in their radial artery.

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So the radial artery is here.

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Now you can practice

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feeling that on yourself, so it is helpful
if you follow your thumb down.

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You can feel that there's a pulse

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at the base of your wrist near your thumb.

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Now you have to be careful
when you're feeling someone's

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pulse not to press too hard
and not to press too softly.

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And that's why we need to practice it,
because like anything, it's a skill

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and it does require time
and effort to become competent at it.

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So you'll notice if you press on yourself,
if you press too hard

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or you go too softly,
you can't feel anything.

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And it is exactly the same
on the mannequins.

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So I know that this mannequin has got
a radio pulse and I can feel it just here.

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If I press too hard,

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I stopped being able to feel anything,
and the reason for that is because

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I've compressed the artery so I can no
longer feel the blood flowing through it.

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And if again, if I press too softly,
I simply haven't pressed far enough down

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to be able to feel it.

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So we've got a number of different
arteries on the mannequin.

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So going to start from the bottom
and work our way up on our feet,

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we do have many, many pulses,
but the one that you're about to feel on

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the mannequin is the pedal pulses
just here on top of the foot.

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And I can feel that very easily there.

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One of the other common pulse points

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that we have on
the body is the femoral artery. So

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in the groin, you can palpate.

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A femoral pulse now,

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it's very difficult
actually to feel on the mannequin.

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But again, it's very good
practice, for you to have to practice

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feeling for an artery
because in the real world,

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when we are palpating our patients pulses,
particularly if a patient is unwell,

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you might not be able to feel their pulse
very easily,

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especially if the patient is very,
very acutely unwell, because they may

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deteriorate to the point where you can't
actually palpate peripheral pulses,

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the ones that are further away
from the center of their body.

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So we've got femoral pulses
on the mannequin,

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and then we have got the radial,
as I've already mentioned.

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We have one
that simulates the brachial artery

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but is higher up than you would
normally have to palpate it on an adult,

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but it is on the inner arm,
on the mannequin.

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Again, I can feel that.

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And then finally, we've got the carotid.

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Which,

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again, is a little bit tricky
to find on the mannequin,

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where it wouldn't usually be in a healthy

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adult patient.

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So what we can do

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as an educator is
we can actually change the settings

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on the mannequins so that we can change,

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the pulse rate.

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So the heart rate and we can change
the qualities of the pulse,

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so for example,
if I change the settings on here.

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So for example, on here,
when I'm looking at heart

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rate, I can actually control

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the patient's heart rate
so I could move it all the way up to 200.

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For example, now if I do that
and then I palpate the patient's pulse.

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It is incredibly rapid.

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Now what I can also do is I can
look at the rhythm, so if we look here,

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they're in sinus

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rhythm at the moment, which is what
we would want our patients to be in.

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I could put our patient
into a number of different types

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of rhythms,
but I would like to put them into atrial

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fibrillation,
which is where the atria of the heart

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are not beating effectively and often
not regularly.

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So if I put them into atrial fibrillation
again, I can keep it nice and quick.

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And what we will find then,
is that the patient's heart

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rate is rapid, but it is irregular,
which is a concern.

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So if you notice that when you are doing

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somebodies observations,
you would need to highlight that to

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whoever it is that you're working
with on that particular day.

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And if you were in the simulated
learning environment,

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you would need to highlight
that to your educator.

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So we've changed the rate
and we've changed it

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to be in atrial fibrillation,
if I put it back into sinus rhythm.

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So in to a nice, normal, healthy
heart rate,

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but I change it down.

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To 20,

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and maybe I'm also going to make
their blood pressure really low as well,

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so I'm making this patient
very, very, poorly now.

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79, over 50
now you can see on this diagram.

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I've done that.

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And what that's done is it's
now ignoring the peripheral pulses.

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So the peripheral pulses are now absent
and you would only be able to palpate

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the pulses in the femoral artery
and the carotid artery.

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So that's these ones here and here.

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That was a little quick summary

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of using the mannequins
to assess your patient's pulse.

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And thank you for watching.